RACHEL ANN WALLACE (NPI# 1568989788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568989788 |
| Entity Type | Individual |
| Full Name | RACHEL ANN WALLACE |
| Credential | BA, CDPT |
| Practice Address |
210 Pacific Ave N Kelso WA 98626-3414 |
| Mailing Address |
Po Box 1847 Longview WA 98632-8140 |
| Practice Telephone | 3604230203 |
| Practice Fax Number | 3605770269 |
| Mailing Telephone | 3604230203 |
| Mailing Fax Number | 3605570269 |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2019-11-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 60336482 | WA | Behavioral Health & Social Service Providers |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2101606 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386829 | Rachel Myrah Wallace | Student in an Organized Health Care Education/Training Program | 185 Doby Rd, Cameron, NC 28326-8185 | 2020-11-04 |
| 1033602131 | Rachel Morgan Wallace | Student in an Organized Health Care Education/Training Program | Primary Health Network, 737 Greenville Rd, Building One, Mercer, PA 16137 | 2018-06-13 |
| 1841704640 | Rachel Wallace | Counselor | 5234 W St Rt 63, Lebanon, OH 45036-8202 | 2017-12-01 |
| 1518578863 | Rachel Wallace | Case Manager/Care Coordinator | 535 Marmion Ave, Youngstown, OH 44502-2323 | 2020-08-11 |
| 1912534363 | Rachel Wallace | Counselor | 3 Cardinal Ln, Newton, NJ 07860-1454 | 2020-03-25 |
| 1912556309 | Rachel Wallace | Nurse Practitioner | 2060 Carlisle Rd, Aspers, PA 17304-9707 | 2019-09-09 |
| 1538717814 | Rachel Wallace | Registered Nurse | 13802 Lake Point Cir Ste 102, Louisville, KY 40223-4219 | 2019-08-29 |
| 1598270894 | Rachel Wallace | Speech-Language Pathologist | 121 E 30th St, New York, NY 10016-7302 | 2017-12-08 |
| 1669719175 | Rachel Renee Wallace | Nurse Anesthetist, Certified Registered | 1311 N Mildred Rd, Cortez, CO 81321 | 2013-01-04 |
| 1447462270 | Rachel L Wallace | Specialist/Technologist | 801 Medical Dr, Lima, OH 45804-4099 | 2007-05-04 |
| Street Address |
210 PACIFIC AVE N |
| City | KELSO |
| State | WA |
| Zip Code | 98626-3414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447619234 | Jessica Ferguson | Counselor | 210 Pacific Ave N, Kelso, WA 98626-3414 | 2016-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730581877 | Wrothell Funchess | Counselor | 1645 Bowmont Ave, Kelso, WA 98626 | 2014-09-19 |
| 1427457688 | Julie Dalen | Counselor | 309 Oak Street, Kelso, WA 98626 | 2014-08-13 |
| 1033468822 | Rene Kerry Bohannon-oxford | Counselor | 2707 Pacific Ave North, Kelso, WA 98626 | 2012-09-07 |
| 1447535737 | Nichole Kathleen Allee | Massage Therapist | 109 Nw 1st St., Kelso, WA 98626 | 2011-10-18 |
| 1689991655 | Zachariah Kramer | Radiology | 700 Lincoln Street Suite 100, Longview Radiologists, Kelso, WA 98626 | 2010-04-29 |
| 1508007071 | Robert Lee Blair | Registered Nurse | 119 Blackburn Lane, Kalama, WA 98626 | 2009-03-13 |
| 1942318829 | Imholte & Anderson Pllc | Dentist | 409 West Main Street, Kelso, WA 98626 | 2006-08-29 |
| 1922088723 | James Bevan Hollingsworth | Pharmacist | 204 S Pacific Ave, Kelso, WA 98626 | 2006-01-18 |
| 1972021087 | Adreia Jenice Jessop | Registered Nurse | 300 Oak St, Kelso, WA 98626 | 2017-09-08 |
| 1023567310 | Charlene Han | Pharmacist | 205 Three Rivers Dr, Kelso, WA 98626 | 2016-09-27 |
| Find all providers in zip 98626 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447619234 | Jessica Ferguson | Counselor | 210 Pacific Ave N, Kelso, WA 98626-3414 | 2016-02-22 |
| 1750612123 | Cristina Duvall | Counselor | 621 Grade St, Kelso, WA 98626-2606 | 2010-01-24 |
| 1679122386 | Anna Saiz | Counselor | 305 Pacific Ave S Ste C, Kelso, WA 98626-1638 | 2019-09-05 |
| 1104488857 | Brittany Lynn Birtchet | Counselor | 404 W Main St, Kelso, WA 98626-1118 | 2019-07-02 |
| 1083278196 | Tessia Renee Taylor | Counselor | 305 Pacific Ave S Ste C, Kelso, WA 98626-1638 | 2019-04-24 |
| 1881151850 | Ryan Lorenzo | Counselor | 404 W Main St, Kelso, WA 98626-1118 | 2019-02-26 |
| 1922564962 | Teresa Lee Brunelle | Counselor | 404 W Main St, Kelso, WA 98626-1118 | 2019-02-14 |
| 1174087613 | Margaret Diane Fraze | Counselor | 305 Pacific Ave S Ste C, Kelso, WA 98626-1638 | 2019-01-29 |
| 1760955272 | Bryanna Marie Jellum | Counselor | 404 W Main St, Kelso, WA 98626-1118 | 2019-01-07 |
| 1467923151 | Kathleen Frances Loney | Counselor | 404 W Main St, Kelso, WA 98626-1118 | 2018-12-06 |
| Find all providers in KELSO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.